A ratchet wrench includes a working head located forwardly on a handle. The working head has a body portion with a generally flat and generally uninterrupted upper surface and a cavity formed in an opposite lower surface with at least one actuator bore through the side wall of the body portion. A drive item is rotatably disposed in the cavity. A pawl item is disposed in the cavity to switch the drive direction of the drive item, and a pawl actuator pin is movably disposed in the actuator bore to switch the pawl. A retention plate may be used to mount the drive item and pawl item in the cavity plate. A quick release mechanism may include a longitudinally oriented and longitudinally slideable release actuator. The upper surface of the working head may be formed by the body portion or by a cover plate mounted thereto.